STOP CONFIRMING APPOINTMENTS …and other tips for reducing cancellations and no-shows

Submitted by Judy Larocque on

By Judy Larocque

It remains one of the greatest frustrations in the day-to-day operation of a dental practice: the patients who calls to cancel with little notice, or who just don't show up for their appointments.

Many practices have come to grudgingly accept this state of affairs as being just a part of the reality that comes with dealing with people and their busy schedules. And it is true that a certain amount of unpredictability will always be there, as urgent matters arise in patients' lives that will bump their dental appointment on the priority list.

The fact remains, however, that there are many patients who are missing their appointments for less-than-urgent reasons. When a patient cancels because they have limited time that day, they are really saying something important about how much they value their appointment with your practice.

Luckily there are things you can do—strategies you can implement quickly— to change patients' mindsets about how they value appointments. Most of it comes down to three basic principles:

Set the right expectations from the start

Most "lost" appointments were not lost on the day you were expecting to see the patient; they were lost the day the appointment was made, because it was not made with the right value.

The only solution is to be clear up front about your expectations. Boilerplate small print text on the appointment card about requiring 48 hours notice is not going to do it—in fact I discourage adding this kind of language to cards, because it encourages people to think of their appointments as being easily changeable. Instead, the team should be trained to have a conversation with patients' that instills the right mindset about appointments. Tell patients "an operatory has been reserved for you"! Get patients to make a verbal commitment on the spot, acknowledging that they understand the expectation on their part. Research has shown that the very act of making an out-loud affirmation dramatically increases a person's likelihood of sticking to their promise.

This is especially important when scheduling large cases, where you are making a greater commitment of resources and time. As well, get new patients into the right mindset about what it means to be a patient in your office. You want them to recognize that in your practice, an appointment is a confirmation. Which leads me to my next point…

Watch your language

The words we use matter, because different words convey different shadings of meaning and create different expectations in the minds of the people we are trying to influence. Take the word "confirmation". For years dental offices have been calling (and writing) patients to "confirm" their appointments. But when you are "just calling to confirm" you are making it sound like the patient has the option at that point to confirm or not. As I said, the appointment should be considered a confirmation at the time it is made, and only extraordinary circumstances should change that.

So what wording should you use? I suggest that you stop confirming appointments and start saying something like, "This is a courtesy call to remind you that you have an appointment with us on Tuesday at 2 pm." It’s a subtle but important difference. You are not asking them to confirm or decline. You are reminding them of the commitment they have already made, and that you are expecting them to uphold.

This is assuming, of course, that you actually get to speak with the patient on the courtesy call. Leaving messages disappear into a communication black hole. And while you don’t want to confirm, you do want an acknowledgement.

So how much energy should you spend on tracking down that acknowledgement? The answer lies in my final point…

Stop babysitting

We live in a hyper-connected world, with so many options for communicating with each other. Postcards and phone calls are no longer an efficient way of managing your patients and their appointments.

A lot of people check their email several times a day. Just about everyone with a smartphone responds to a text in short order. Why not use these methods to streamline the process of ensuring that patients keep their commitments? Just make sure to get that acknowledgement—a simple "type 'OK' to acknowledge that you have received this message" is usually all it takes.

How do you know which patients respond best to which mode of communication? Ask them, ideally at the time their first appointment is made, say "Which is the best way to get in touch with you if we need a quick response? Cell phone? Email? Text?"

In the end, though, these are just techniques to optimize your team's time. The real solution to getting near-perfect attendance in your dental chairs will always come back to how much the patient values the treatment. If you find yourself chasing patients to get an acknowledgement, you are taking on the responsibility for their actions, because you are more invested in the appointment than they are. You're babysitting.

The real breakthrough comes when patients take ownership for the commitments they make. That happens when they have been presented with a consistent value message from everyone in the practice—from the clinicians who propose treatment to the front desk team who sees them out the door. It's a message that says ,"We expect you to respect our commitment to you by respecting your commitment to us."


Judy Larocque has been involved in the dental practice management industry for over 30 years. She has headed the consulting division of Mercer Advisors, where she was responsible for training and overseeing teams of practice consultants, and she herself has helped countless dental practices across North America get back on track and optimize their success. She has been the Director of Consulting Services at IDI for over 8 years. You can reach our new director, Isabelle Lavallée, at isabelle@idi.org.


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